Obviously, accidents are, well, accidental, but if we purposefully avoid identifying relative responsibility, then we risk putting ourselves and others through them again. After all, if we don’t take responsibility for accidents that are not largely accidental, we miss an opportunity to prevent them. And if we do take responsibility for accidents that are entirely accidental, we compound the misery unnecessarily, which may make more accidents happen. So, instead of getting swept up in shame or guilt, add up the facts and seek second opinions. Accidents happen, but if you don’t learn from them you’re deliberately setting yourself up for more mistakes.
–Dr. Lastname

My sister drinks because she says it’s the only way to make her anxiety go away—her anti-depressants don’t do it—but she’s been hospitalized three times now because of blackouts caused by drinking and taking extra medication. She gets mad when they try to keep her at the hospital for observation because she always says that she didn’t want to kill herself, she was just trying to get some relief for depression and screwed up by drinking, and being at the hospital makes her more depressed and then she signs out as quickly as possible. She’s mad at me and the rest of the family for insisting that she has a problem with alcohol and needs help, because she thinks we’re just freaking out over a few stupid mistakes and we’re doing this because we like to make her feel worse. My goal is to find her the help she needs.

As you already know, the only problem your sister will admit to having is the one she has with you and your insane overreacting, and maybe also one with your family, who should love her the most but are making her difficult life even more excruciating. You almost can’t blame her for turning to the bottle.

What’s hard for you to accept, of course, is that you can’t get through because, from what you’ve described, her mind is focused entirely on the way she feels in the moment, and in most moments, it’s lousy.

She might have even felt suicidal at the time she almost died, but since she doesn’t afterwards, what was a suicide attempt is now, in her estimation, a silly mistake. As such, she’s not lying, she’s just incapable of seeing the big picture. Shrinks call people whose depressed and angry feelings distort things this way “borderline personality disorders” and, when their distortion is as severe are your sister’s, there’s nothing much that can help them, at least not for the time being.

So don’t try to argue or tell her how much she needs help. Instead, simply trust yourself and act according to what you see and believe. You can’t promise her that she’ll feel better if she stops drinking, particularly not at first. You can promise her, however, that treatment and sobriety can help her think more positively, act more carefully, and reduce the risk of accidental overdose and death if she truly wishes to build a better life.

While the whole concept of “shoot first, ask questions later” sounds cool to many of us, it obviously has some detractors (namely, those who were shot before they could have been vindicated through question-asking). In reality, as always, you need to strike a balance, because, while asking questions can sometimes interfere with action, taking action can be a way to avoid asking difficult questions. So, instead of assuming that either is good without the other, learn how to limit your questions to those that are necessary and how to take action, hopefully unarmed, even when you’re not sure how things will turn out.
–Dr. Lastname

I’ve been taking a medication for several years that has been very good for my depression, but now I’m having obsessive thoughts and my doctor thinks I should take a larger dose and see if it reduces the OCD. She says there’s always an advantage in taking one medication instead of two, and that a month of taking a larger dose every day will tell me whether this medication can help all my symptoms or whether I need to try something else. It’s hard for me to take the same dose every day, because the medication makes me jumpy, so I always take less when I need sleep and then I take more when I need to be awake. In addition, I read on the internet that larger doses might make me fat, or, in some cases, suicidal, so I have a lot of doubts about this increased dose, and a lot of questions that nobody seems able to answer. My goal is to find somebody who has the answers (you?) and figure out the best way to deal with my obsessive thoughts.

If you’re having obsessive thoughts, and both you and your doctor acknowledge this to be a problem, then maybe you shouldn’t take your endless doubts about medication at face value. You can’t alleviate obsessive thoughts by entertaining them, which is what you’re doing here.

It’s valuable, of course, to make careful decisions about medication, and your questions would be useful if your medication were really designed to work quickly and help you stay awake. Instead, it’s designed to help you stop obsessing about factors like these, and to do so at its own pace. WAIT! There is more to read… read on »

It’s strange that, as children, we’re pushed to declare what we want to be when we grow up, and then get disappointed with ourselves when we can’t achieve that goal, even though most kids want to grow up to be king or a dinosaur. If you get to adulthood without an idea of what you want to be, plausible or no, you may feel doomed if uncertainty and indecisiveness make such decisions difficult or illness makes your chosen path impossible. In reality, what matters most is not choosing a career or doing well at it, but being a decent and independent person as you find your way in life. Then, whether a career appears or, like the dinosaurs themselves, comes to a premature end, you will grow to be a strong person who can be proud of your choices.
–Dr. Lastname

I’m in my mid-20s and struggling from some choice-paralysis in regards to my career. I went to college on the other side of the country a few years ago and obtained an arts degree (I know, I know – bad move), and am doing administrative work. I find it deeply unsatisfying but it pays quite well, considering. I also know that if I wanted, I could build a solid career here in something practical, I would just have to decide which career. On top of that, my family is here, and I’ve taken up meaningful volunteer work. I have some friends with their masters that are starting up serious careers, and then some that are doing things like buying houses and getting pregnant, which makes me feel like maybe I should just find a boyfriend and start settling too. On the other hand, I deeply want change, a bigger city and different industry options. I got into a program at a college in a bigger city on the other side of the country, and it’s probably as useless as my current degree, but I would love to go back to school and be more qualified in something. Also, this city I would be moving to has more varied industries. But leaving my job and going back to school on the other side of the country means I would have to take out more student loans which just seems stupid. I know there is no right answer and that everyone goes through this in a way—if I go, I can always come back—but the part of me that wants to be pragmatic knows that with my current debt, moving would actually set me back a lot. My goal is to reconcile my desire for a cool arts job in a bustling city with my growing desire to be practical and either make a decision to find something that works for me here, or move, explore other options, and not look back.

Like marriage, a career is about the long game and shouldn’t be judged by its immediate rewards, be they to your mood, wallet, self-esteem, etc. Besides, while marriage is hard work, a career is just hard work; the only way to get the same kind of bliss from a new job as you would as a newly wed is to start working in porn.

Once you take that into account, it’s becomes easier to simplify your career choices, particularly when it comes to work, going to school, or change in general. Right now, in your mid-twenties, you have a great opportunity to explore career options, new cities, even sexualities if you’re so inclined, all without having to worry too much about pay or security. WAIT! There is more to read… read on »

When faced with a seemingly insurmountable issue—an illness, personality flaw, really ugly feet—most people think that getting to the bottom of that issue and finding an answer of some kind is their ultimate goal, when in reality, it’s just the beginning. Too often, they’re actually looking for someone to blame or focusing on one small problem and ignoring the big picture. So don’t let helplessness guide your assumptions, your searches, or your choices in footwear. Ask yourself what answers you’re really looking for and whether you actually know more or less than you think you do and, given that knowledge, whether anything other than life is really to blame.
–Dr. Lastname

I can’t stand seeing how depressed my husband is, and no medication seems to help. Several things he tried were very promising at first but then pooped out or quickly caused side effects that made him even more miserable. I can’t get a straight answer from his doctors as to why they’re not working or whether his symptoms are from his illness or being over-medicated. No one seems to know what they’re doing, or what to try, or why the medication isn’t working, or when to stop when they’re not working…I feel really lost. My goal is to find some way to get his treatment on track.

When treatment doesn’t work, it’s natural to feel helpless and look for an explanation. Both fortunately and unfortunately, for most psychiatric problems, the answer is simple– treatment often doesn’t work.

Remember, the scientific meaning for “effective” is “better than nothing,” not “usually works.” And when “better than nothing” translates to “maybe less terrible than normal,” it’s easy to feel effectively screwed. WAIT! There is more to read… read on »

Telling the unadulterated truth can be an intoxicating experience; revealing a dangerous secret can give extreme sport-levels of exhilaration, and the thrill of hearing a secret exposed is why most people watch any locale of The Real Housewives. Unfortunately, also like extreme sports, the adrenaline rush of secret-sharing is often followed by a painful, embarrassing crash. Sometimes you can be more helpful by keeping private information to yourself, and sometimes you can acknowledge a secret while being respectful. In any case, think carefully about consequences before you decide how much exposure is necessary and prepare to explain this necessity with respect. Then you’ll be a good judge of when to shut up and how to share and keep your friendships/bones/dinner party invitations intact.
–Dr. Lastname

I don’t know when my depression started, but the symptoms became pronounced when I was in high school. I started seeing a doctor and taking medication when I was in college, and twenty years later, that’s still what I do for treatment. I told my wife about my depression while we were dating, and my close family know about it, but I’m not very open about it besides…I’m a private person overall, and I don’t want to deal with being judged by others. Now that my son is in high school, exhibiting the same symptoms that made my adolescence so difficult, I’m worried that keeping quiet about my own illness wasn’t the right thing to do, and I’m not sure what advice to give my son, either. I think I should tell him about my own experiences, because I want him to know that he’s not alone or weird, and that he shouldn’t be ashamed of being sick, but I don’t want him to be totally open about his illness, given how the other kids might treat him. Then again, I worry that keeping quiet about our illness just perpetuates the stigma…one of my brothers is gay, so it reminds me of what he went through when he came out, if that makes sense. Then again, my brother didn’t want to be a poster child, and neither do I, but maybe, for my son’s sake, I should be? My goal is to figure out how to talk to my son about his depression, and how and if to talk to others about my depression, also.

Some people feel liberated by sharing all their secrets, but most people, especially those of us who came of age before Facebook, enjoy our privacy. If you’re an especially private person—you don’t feel compelled to tell the world what you ate for lunch, let alone what your prescriptions are—then sharing information about illness is an especially uncomfortable prospect.

Even when an illness is stigmatized, however, there are unique criteria for making your decision, with specific benefits to both disclosure and privacy. It’s your job to figure out which is more important given the unique facts of your situation and your son’s.

If you were a celebrity, then being totally open about your disease would give you the chance to reach out to and help others, but as a regular guy, the only person who will consider you a role model is your son. You can find the level of openness that works for you without having to be a poster child (which, for the depressive community, means being down-and-out and proud). WAIT! There is more to read… read on »

It’s remarkable how often people are blind to the true nature of their relationships; even more remarkable than the resulting number of bad conflicts, really bad romantic comedies, and truly horrific divorces. The only thing more frustrating than being blind is having to act as a seeing-emotion guide to one or both of the parties involved, either because you want them to ignore their differences or wise up to them. In any case, telling them how you feel about how they feel will probably make things worse. All you can do is remind them of their duty to do what’s right for themselves and hope that experience helps them see their way out of a horrible, unremarkable outcome.
–Dr. Lastname

I’ve got two guys working in my warehouse who both do their jobs, but they can’t get along with one another, and their squabbling puts everyone on edge. The younger guy is very motivated and hardworking, but he feels the older guy is stupid and slows him down, and he gives him crap about it. The older guy isn’t lazy, but he is a little stupid and slow, plus he’s sensitive and he feels the younger guy doesn’t respect him, which is true. I’m their boss, so they both complain to me, but I don’t want to lose either of them because it’s a pain to train someone new. Plus I like them both, I just can’t stand how much they hate each other, and I can’t get them to sit down and work it out because it’d make things worse. My goal is to get them to get over this bullshit and get back to work.

As their boss, you have a right to insist that people working for you treat one another with respect and leave it to you to judge whether or not they’re competent. More realistically, however, bosses really just have the right to mediate between childish employees and absorb animosity. All this for better benefits and your own parking space.

Of course, being that you’re more like a father than an enforcer to your employees, you have as much power to make them get along as you do to get your kids to stop bickering in the minivan. WAIT! There is more to read… read on »

Human beings have figured out how to get to space, train a dog to recognize letters, and make a sandwich where the bread is actually chicken, but we’re still generally at a loss when confronted with the offer of help. It shouldn’t be that confusing, but accepting help can be necessary while feeling humiliating, or it can be humiliating while feeling necessary, and either way, the answer is remarkably unclear. Once you know what you need the help for and whether it’s necessary for your personal goals, however, then you’ll know whether it’s good for you, regardless of how it feels or looks to anyone else. It might never be easy to accept or refuse help (or eat meat on two pieces of poultry), but it’s easy to figure out whether accepting is the right thing to do.
–Dr. Lastname

I know I’ve been a total fuck-up for the last few years, and my family thinks I’ve blown through all my savings and gone into debt besides, but the truth is worse than they think. And because I know it’s all my fault, I get really depressed and angry at myself, which makes it impossible to get the courage and energy to try to get back on track. I’m too afraid and ashamed to talk to anyone, so my friends and work contacts have pretty much disappeared. Insanely, my parents and brothers still care enough to offer to help me get back on my feet, but I know they’re just offering out of pity, and I won’t be able to live with myself when I lose their money and let them down. My goal is to rescue myself without my family having to pick me up.

You might have thought your mom, little league coach, and/or high school girlfriend were full of shit when they tried to console you for a poor result, but they were right when they said that a good effort is more valuable than a great deal of success. Equating success with winning would explain why you feel like such a loser right now.

The higher your standards and/or self-opinion, the deeper the rut when your winning streak ends and the steeper the metaphorical climb back to an acceptable normal. That’s why, at a time you most need energy, focus, and social skills, shame for being less-than-excellent keeps you trapped in an emotional crevasse.

The only antidote to feeling like you’re insanely ungreat is to remember that life is hard, luck is important, and you’re always doing right if you’re ready to work and trying to be independent. Basically, you can’t hold yourself responsible for success or failure, just for the effort you make to achieve the former and avoid the latter. WAIT! There is more to read… read on »

Some medical issues can be resolved quickly, but most of the serious ones aren’t that easy; for every temporary infection and sprain, there’s the eternity of diabetes and, of course, mental illness. Just because your crazy isn’t going away, however, doesn’t mean you can’t try to figure out how to lead a sane life anyway. And if you can get your crazy under control, you have to stay vigilant in order to keep it that way. So don’t try for control that is perfect or permanent; that’s as farfetched as a cure. Prepare to take one drug and one symptom at a time until you know what you have to deal with and what works best for the long run. Even if you can never cure the pain, you don’t have to let it be an overwhelming pain in the ass.
–Dr. Lastname

I’m not depressed any more, but going to the hospital and taking medication didn’t change the fact that my wife looks at me in a different way than she used to, and she spends more time at the gym, where there’s a handsome trainer who knows her name. She says I’m crazy and paranoid because this guy’s gay and just being friendly and, after twenty years of raising the kids, she’s too tired to mess around anyway, but I know what I see. And there have been signs in the way she seems happier and sweatier when she gets home from working out and her sweat smells more manly than feminine. My goal is to get someone to see that it’s more than coincidence, and that I have good reason to feel she can’t be trusted, and I’m not just nuts.

The paradox of feeling paranoid is that validating your fearful suspicions is what you both crave and dread the most. If you’re right, then you’re not crazy, but neither are your worst fears; your sanity may be intact, but your world would be destroyed.

Having those fears invalidated isn’t so hot, either, because it means that you can trust the world around you, but your own brain is suspect. So if proving and disproving your suspicions will always end badly, learn how to give less weight to those nagging thoughts in the first place. WAIT! There is more to read… read on »

Strong emotions often push us to act without weighing consequences, simply because we feel helpless and need to take action; that’s why the world has so many unworn expensive shoes, memorial tattoos, and children born just before or after their parents’ divorce. In reality, we’re often screwed no matter how we choose to react, or we’re just panicking for no reason and no action is required in the first place. In any case, no matter the emotional forces, think first and act later, weighing your alternatives and acting only if you think it’s necessary. You might not feel any immediate relief, but in the long run, you won’t have anything (or anyone) to regret.
–Dr. Lastname

My grown son has always been very difficult, but his last outburst was just too much. He caught me at a time when I was having a tough time and felt vulnerable, and I told him I thought he was being a selfish, self-centered little shit, so he told me never to talk to him again and hung up. Unfortunately, even if I shouldn’t have said those mean things out loud, I was right; he’s a jerk, so none of his friendships has lasted and his kids are very careful not to aggravate him. Even though I feel really guilty about it, I just can’t bring myself to pick up the phone or write him and try to patch things up. I know that if I don’t reach out to him, I won’t see those kids, but if I do, I’ll have to have a conversation with him, which is just going to be unpleasant and end badly. My goal is to figure out a way to repair our relationship so I won’t dread talking to him or feel bad about being such a heartless parent.

The good news is that you’re living evidence that Asshole™-ishness isn’t always genetic. The bad news is that you have still spawned an Asshole™.

As we’ve said before, Asshole™s can cause serious harm without any real provocation; they’re usually very needy, and their neediness causes them pain that they think is your fault, particularly if you’re a parent or other person who stirs up those feelings by virtue of your very existence.

Strong feelings, like sports victories and financial losses, often seem inherently important and noteworthy, but, in reality, they mean very little taken out of context. Sometimes you feel something strongly just because you’re especially touchy (or don’t feel that much because you’re comfortable and momentarily undisturbed), so, as with an extra-inning win for a team that’s already been eliminated or a million dollar loss to a billionaire, it’s a small blip in the bigger picture. Don’t then jump to conclusions about your strong feelings, or their absence, until you’ve considered what you’re after and what you consider most important. Then you’ll know whether your feelings are a big deal or a bunch of nothing.
–Dr. Lastname

Let me preface this by saying that I am seeing a psychiatrist and on two medications, yet I continue to struggle with depression, as well as multiple sclerosis (MS). My problem though involves my husband, who has been my rock. When I met him, he was a hunk. We created two gorgeous children thanks to his gene pool; I often think that if I didn’t carry them people wouldn’t believe they were mine! He is a stand-up guy who comes from a great loving family, does the laundry, buys the groceries and cooks when I can’t— he even makes the coffee every the morning. I absolutely love my husband, but…am I still in love with him? I know that he’s great, and the sex isn’t bad, but I’ve just lost that loving feeling, as the saying goes. My goal, I guess, is to get that loving feeling back.

Many feelings—loving, hating, hurting, etc.—are sometimes experienced more intensely by people with MS because of subtle changes in the brain. It can act like a magnifying glass, blowing up your every emotion and, in some cases, leaving a burn.

In your case, your love for your husband hasn’t intensified, but your need to feel in love with your husband, and awareness that you aren’t as intensely in love as you once were, have become overpowering. And having strong feelings about weak feelings can feel like a strong force striking your brain.

Luckily, there’s no reason you can or should change your feelings. What you should do, however, is question their importance when compared with your values, sense of the alternatives, and the possible influence of your illness. WAIT! There is more to read… read on »